摘要
目的评价大野套小野后程超分割放射治疗上段食管癌的疗效及预防照射双锁骨上淋巴结的意义。方法将82例上段食管鳞癌随机分为两组。常规分割组,前大野后小野同时对穿照射,2.0Gy/次,1次/d,5次/周。照射至40Gy后缩野改为等中心照射,总剂量达DT60Gy,锁骨上预防照射DT45Gy,总疗程6周。后程超分割组,前4周采用常规分割,后两周采用超分割方法,即1.5Gy/次,2次/d,间隔6h,总剂量70Gy,6周完成。结果完全缓解(CR)率和总有效(CR+PR)率,后超组分别为70.7%和97.5%;常规组分别为53.7%和92.7%。2个组1年生存率比较差异有显著性意义(χ2=5.67,P=0.025)。后超组:1、2、3年生存率分别为82.0%、61.5%、48.7%,常规组分别为64.8%、48.6%、37.8%。后超组1、2、3年局部控制率分别为79.4%、53.8%和46.1%,常规组分别为56.7%、45.9%和37.8%。2个组1年局控率比较有明显差异(χ2=4.540,P=0.033)。结论后程超分割照射食管癌可提高局部控制率。
Objective To evaluate the therapeatic result of upper esophageal carcinoma treated by late course hyperfractionation radiotherapy with the field-in-field technique and to define the benefit from prophylactic irradiation of the bilateral supraclavicular and superior mediastinal lymphatics.Method: Eighty two patients with upper esophageal carcincma were treated by conventional radiotherapy (CRT-41 patients) or late course hyperfractionation radiotherapy(LCHR-41 patients).The CRT patients were irradiated by a wide anterior portal and small back portal at 2 Gy once daily,5 days per week. After 40 Gy, the radiation fields were coned-down and the radiation dose was increased to 60 Gy at the prior lesion and 40 Gy in the supraclavicular regions, The LCHR patients were treated with the same three-portal technique at 1.5 Gy per fraction, twice daily with a minimun interfration interral of hours,5 days per week.40 Gy were delivered through the large anterior portal and 30 Gy through posterior oblique portals.Results The complete response(CR) rate and total response(CR+PR) rate were 70.7% and 97.5% in the LCHR group. They were 53.7% and 92.7% in the CRT group. One year survival rates between these two groups showed the significant difference(χ~2=5.67, P =0.025). The 1-,2-,3-year survival rates were 82.0%、61.5%、48.7% and 64.8%、48.6%、37.8% in the LCHR and CRT groups. The difference in 1-year local control rates between these two groups were statistically significant (χ~2=4.540, P =0.033).Conclusion Late course hyperfractionation radiotherapy plus concurrent chemotherapy can improve the local control for upper thoracic esophageal carcinoma.
出处
《河南肿瘤学杂志》
2005年第3期197-199,共3页
Henan Journal of Oncology
关键词
食管肿瘤
后程超分割
预后
esophageal neoplasms
late course hypertractionation radiotherapy
prognosis
